Microsurgery is the manipulation or suturing of very small anatomy such as arteries, veins, ducts, or nerves. These procedures require high visual magnification and specialized precision instruments as well as advanced fine motor skills. Supermicrosurgery is microsurgery on an even smaller scale. Now, new supermicro instruments developed specifically to address the challenges of supermicrosurgery can ensure successful patient outcomes.

Medical Microinstruments, Inc. (MMI, Misa, Italy) has launched its new Supermicro NanoWrist instruments for use with the Symani Surgical System, developed specifically to address the challenges of microsurgery. Symani has enabled lymphatic surgery by adding precision that not every surgeon can achieve, even with extensive training, when manually suturing extremely small vessels. The tips of the new instruments are half the width of MMI's standard microinstruments with a tapered design optimized to connect vessels under one millimeter in diameter and delicately hold 10-0 to 12-0 sutures.

Recently, the new supermicro needle holder and dilator were successfully used in a clinical procedure called a partial glossectomy, where surgeons raised a lateral arm free flap to replace a large section of a patient's tongue which required removal due to cancer. To return blood flow to the transferred tissue, the surgeons needed to connect the branch of the radial collateral artery to a side brand of the superior thyroid artery that was only 0.8mm in diameter and in a difficult location to access. MMI's Supermicro NanoWrist instruments are commercially available in the European Union (EU).

"We've already seen the benefits of Symani and the NanoWrist instruments in improving dexterity and control," said Dr. Simon Enzinger, MD, DDS, surgeon at the Department of Oral and Maxillofacial Surgery at the University Hospital Salzburg, who used the new instruments. "The new supermicro instrument tips are even smaller and more refined, making it significantly easier to precisely connect vessels under one millimeter in diameter. I believe this will expand the ability to use perforator-to-perforator flaps, which makes free-flap surgeries shorter and less invasive."

"The launch of our new supermicro instruments is a significant milestone as we push the boundaries of robotic surgery to address even smaller vessels that few surgeons are able to connect by hand," said Mark Toland, CEO of MMI. "We're excited that our innovative solutions will allow more surgeons to perform microsurgical techniques and help expand patient access to supermicrosurgeries for chronic illnesses like lymphedema, a burdensome condition that affects 250 million people around the world." 

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